Energy-enhanced, hand-held vascular sealer

ABSTRACT

A hand tool has a pivot connection pivotally attaching a first arm to a second arm, with the pivot connection fixed relative to the first arm and movable to first and second positions relative to the second arm. A spring urges the pivot connection into the first position. When jaws on the front ends of the arms clamp tissue with force greater than a pre-set threshold, the spring force is overcome and the jaws may move linearly apart, allowing for more uniform clamping of the tissue. The first arm may have an arm spring extending between a front segment pivotally attached to a rear segment of the first arm.

CROSS REFERENCE TO RELATED APPLICATION

The present application claims priority under 35 U.S.C. § 119 to U.S.Provisional Application Ser. No. 62/581,295, filed Nov. 3, 2017,entitled HAND-HELD GRASPING DEVICE, the disclosure of which isincorporated herein by reference.

BACKGROUND

The present disclosure relates to a hand-held tool for gripping and/orcompressing an object.

Various designs of plyers-type hand-tools have been proposed forspecific applications. Generally these tools have two pivotally attachedarms with the arms acting as levers to increase the gripping orcompression force applied by jaws at the front end of the arms. In themedical and surgical field, hemostats and surgical clamps are examplesof these types of tools.

One specific, non-limiting example in the surgical field is removal ofpart of the liver (hepatic resection), which is often performed toremove a tumor. Blood loss is a serious complication associated withthis procedure. Multiple surgical techniques and devices have beendeveloped to minimize blood loss and improve outcomes in hepaticresection. The so-called clamp-crush technique is a preferred technique.

The clamp-crush technique generally involves crushing the liverparenchyma using a hemostatic clamp tool to expose small vessels andbiliary radicals, which are then sealed and then divided via radiofrequency (RF) energy provided to the jaws of the tool. Various toolshave been proposed for this purpose. However, challenges remain inproviding a coaptive surgical sealing tool offering superior performanceand efficiency in a simple and low-cost design.

SUMMARY

A hand tool has a pivot connection pivotally attaching a first arm to asecond arm, with the pivot connection fixed relative to the first armand movable to first and second positions relative to the second arm. Ajaw spring urges the pivot connection into the first position. When jawson the front ends of the arms clamp with force greater than a pre-setthreshold, the spring force of the jaw spring is overcome and the jawsmay move linearly apart, allowing for more uniform clamping. An armspring in the first arm may limit the clamping force that may be appliedto the clamped object.

In one aspect, there is disclosed A hand-held tool comprising: a firstarm having a first jaw section and a first handle section; a second armhaving a second jaw section and a second handle section; a pivotconnection pivotally attaching the first arm to the second arm, whereinthe pivot connection is fixed relative to the first arm and movablebetween first and second positions relative to the second arm; and a jawspring urging the pivot connection into the first position.

In another aspect, there is disclosed A hand tool comprising; a firstarm having a front section pivotally attached to a rear section via anarm hinge pin; an arm spring extending between the front section and tothe rear section of the first arm; a jaw hinge pin pivotally connectingthe front section of the first arm to a second arm, with the hinge pinat a fixed position on the first arm, and the hinge pin movable intofirst and second positions relative to the second arm; and a jaw springurging the hinge pin towards the first position, and wherein the hingepin is movable against the bias of the spring into the second position,wherein the front sections of the first and second arms may be spacedapart and substantially parallel to each other.

In another aspect, there is disclosed a hand tool comprising; a firstarm having a front section pivotally attached to a rear section via anarm hinge pin; an arm spring extending between the front section and tothe rear section of the first arm; a jaw hinge pin pivotally connectingthe front section of the first arm to a second arm, wherein the hingepin is at a fixed position on the first arm, and the hinge pin ismovable into first and second positions relative to the second arm; ajaw spring urging the hinge pin towards the first position, and with thehinge pin movable against the bias of the spring into the secondposition wherein front sections of the first and second arms may bespaced apart and substantially parallel to each other; a first electrodeon the front section of the first arm, and a second electrode on a frontsection of the second arm; wire leads on at least one of the first andsecond arms connecting to the first and second electrodes; and anirrigation line in or on at least one of the first and second armsconnecting to front section of the first or second arms, and anaspiration line in or on at least one of the first and second armsconnecting to the front section of the first or second arms.

Other features and advantages should be apparent from the followingdescription of various embodiments, which illustrate, by way of example,the principles of the disclosure.

BRIEF DESCRIPTION OF THE DRAWINGS

In the drawings, the same element number indicates the same element ineach of the views.

FIG. 1 is a front, top and side perspective view of a hand tool.

FIG. 2 is a side view of the tool shown in FIG. 1.

FIG. 3 is an enlarged detail view of the tool of FIG. 1.

FIG. 4 is a front, top and side perspective view of a second embodimentof a hand tool.

FIG. 5 is an enlarged section view detail of the tool of FIG. 4.

FIG. 6 is an exploded perspective view of the tool of FIG. 4.

FIG. 7 is an enlarged perspective view of the jaws of the tool of FIG. 4in an open angle position.

FIG. 8 is a side view of the tool of FIG. 4 in the closed position.

FIG. 9 is a side view of the tool of FIG. 4 in the open parallelposition.

FIG. 10 is a front, top and side perspective view of another embodimentof a hand tool.

FIG. 11 is a side view of the tool shown in FIG. 10.

FIG. 12 is an enlarged top, front and side perspective view of the firstarm of the tool shown in FIGS. 11 and 12.

FIG. 13 is a front, top and side perspective view of another embodimentof a hand tool.

FIG. 14 shows another embodiment of a hand tool.

FIG. 15 shows a perspective, enlarged portion an arm of the tool.

FIG. 16 shows a side view of the arm of FIG. 15.

FIG. 17 shows another embodiment of a hand tool that has a removable jawsection.

FIG. 18 shows the hand tool of FIG. 17 with the removable jaw sectionattached to a handle section of the tool.

FIG. 19 shows a schematic representation of a coupling mechanism thatcouples conduits of the jaw section to conduits of the handle section.

FIGS. 20 and 21 show another embodiment of a hand tool.

FIG. 22 shows an enlarged view of a region of the jaws of the hand tool.

FIG. 23 shows the hand tool and a blade assembly.

DETAILED DESCRIPTION

Disclosed is a hand tool for uses such as, for example, generalmanufacturing, assembly, and repair where grasping, clamping and/orholding is needed. The tool is sometimes described herein in the contextof being a coaptive surgical sealing tool although it should beappreciated that this is just an example and that the tool is configuredfor use in a variety of situations.

As shown in FIGS. 1-3, a first embodiment of a hand tool 20 has a firstarm 22 pivotally attached to a second arm 52 at a hinge joint 44. Thefront section (forward of the hinge joint 44) of the first arm 22 has afirst jaw 24 and the front section of the second arm 52 similarly has asecond jaw 54. A grabbing element, such as a finger ring 26, is providedat the back end of the back section 28 of each of the arms 22 and 52.The second arm 52 includes an arm slot or opening 56, with a reducedwidth hinge section 30 of the first arm 22 positioned within the slot56. Referring to FIG. 2, where the tool 20 is configured as a surgicaltool, wire leads 60 and 62 may optionally be provided on or in one orboth arms 22 and 52 to electrodes 66 and 64 on the arms 22 and 52. Thewire leads 60 and 62 may terminate at a connector on one or both of thearms, to allow energy such as RF (radio frequency) or microwave energy,to be supplied to the electrodes. In an embodiment, the energy is at afrequency of at least 100 kHz. In another embodiment, microwavefrequency is greater than 300 mHz. Any of the embodiments describedherein can be configured for RF (radio frequency) or microwave energy.

As shown in FIG. 1, for applications such as surgery of the liver, thejaws 24 and 54 may be made long and slender, for example with a lengthfrom the hinge joint 44 to the front tip 46 of each jaw ranging fromabout 20 to 80 mm, or 30-40 mm, and with jaws having a maximum width andmaximum height of about 1.5 to 5 mm. The jaws may taper outwardly inheight and width from the front tip to the hinge joint 44, with thewidth and height of each jaw 1 to 2.5 times greater at the hinge joint44 than at the front tip 46. The jaws 24 and 54 may also curve to oneside, such as the left side in the example shown in FIG. 1. It should beappreciated that the aforementioned dimensions are just examples andthat variations are within the scope of this disclosure.

Turning to FIG. 3, a spring arm 40 of a spring 34 may be attached to thefirst arm 22. The spring 34 may have spaced apart upright clevis plates36 on opposite sides of the second arm 52, with a hinge pin 42 extendingthrough the plates 36 and the second arm 52 to form the hinge joint 44.The hinge pin 42 is movable via flexing of the spring 34, from an up oropen position shown in FIG. 3, to a down or closed position shown inFIG. 2. In the up position the hinge pin 42 is raised up and largely outof a recess 32 in the first arm 22 as shown in FIG. 3. In the downposition the hinge pin 42 is largely within the recess 32 as shown inFIG. 2. As shown in FIG. 2, in the down position, the plane or axis ofeach jaw may be centrally aligned with the hinge pin 42, with the jawsparallel to and in contact with each other. The hinge pin 42 defines anaxis of rotation of the first arm 22 and the second arm 52 relative toone another wherein the axis of rotation can change position based onthe position of the spring arm 40.

Referring to FIG. 2, in use the jaws 24 and 54 are opened, moved toengage an object, such as a work piece, or tissue, and then closed. Withnominal clamping pressure applied, in a surgical application the jawsmay act as conventional hemostat or clamping jaws, as shown in FIG. 2.However, if greater clamping pressure is applied, the force acting toseparate the jaws exceeds the force of the spring acting to hold thehinge pin 42 in the down position. As this occurs, the hinge pin 42moves up (or away from the first arm 22) towards the up position shownin FIG. 3. Correspondingly, the jaws move linearly away from each otherrather than to the teen relative to one another. As a result, the jawsare able to clamp the work piece, or tissue, with more uniform clampingforce. The linear separating movement of the jaws may be limited by afinger 38 on the first arm providing a hard stop position against thespring 34. The linear separating movement of the jaws depends on thereaction force on the jaws (acting to separate the jaws). Depending onthe geometry of the clamped object or tissue, the linear separatingmovement may be independent of the pivoting movement or angular positionof the jaws.

With the jaws closing at an acute angle as shown in FIG. 2, the clampingforce is greater closer to the hinge joint 44 and less at the tip 46, sothat the clamping force may vary significantly. With the tool 20,however, after a pre-set clamping force is exceeded, the jaws move apartlinearly, helping to provide a more uniform clamping force. As shown inFIG. 3, the jaws may remain substantially parallel as they move linearlyapart. The pre-set clamping force is selected via the spring constant ofthe spring. Different embodiments of the tool 20 may have springs withdifferent spring constants selected for use in different hand tool uses,or different surgical procedures. For a non-limiting example, the springconstant may be in the range of 2-8 Newtons/meter or 36 Newtons/meter.

In the configuration shown in FIGS. 1-3, the hinge pin 42 moves in anarc having a radius equal to the length of the spring arm 40.Consequently, as the jaws move linearly relative each other, there isalso a small front/back movement as well. Hence, with the jaws fullylinearly open, and the hinge pin 42 in the full up position, the secondjaw is positioned slightly behind the first jaw 22, as shown in FIG. 3.Clearance to allow for this slight longitudinal shifting between thejaws may be provided via the leg slot 56. The hinge pin 42 verticalrange of travel may be about 2-10 or 3-7 mm.

Turning to FIGS. 4-6, in a second embodiment 80, a first arm 82 ispivotally attached to a second arm 84 via a hinge pin 86. Latch plates92 may be used to latch the arms. As shown in FIG. 5, as applied to asurgical hand tool, electrical leads 60 and 62 along with an irrigationline or drip 120 and an aspiration or suction line or tube 122 mayextend on or in either arm to electrodes 96 and 100 on first and secondarms 94 and 98. The tubes or lines 120 and/or 122 may be routed in ajoggle around the hinge pin 86. As shown in FIG. 6, the first arm 82 maybe provided with separate front and back sections 114 and 116, such asto allow for easier manufacture. The first arm 82 may be positionedwithin an arm slot 90 of the second arm 84. Also as shown in FIG. 6, aninsulator plate or layer 130 may be positioned between the arms 94 and98 and the electrodes 96 and 100. Irrigation and aspiration lines mayalso be provided on the tool 20.

As shown in FIG. 7, the electrodes 96 and 100 may have angledcomplimentary surfaces 102 and 104 joining together at an edge 106adjacent to the tip 46. Aspiration and irrigation openings 124 and 126connecting with the aspiration and irrigation lines may be provided inthe electrodes 96 and 100. As shown in dotted lines in FIG. 7, theaspiration openings 124, if used, may also be located on a top and/orside surface of one or both jaws, in addition to, or instead of,locating the aspiration openings in the electrodes. The electrodes 96and 100 may have complimentary shapes, so that the jaws mate uniformlywhen closed, with little or no space between them. The inner surfaces ofone or more of the arms may be textured or can have any surfacecharacteristic, such as serrations, that improves the gripping abilityof the arms relative to tissue or other material. The serrations, ifpresent, may also be shaped to bias any irrigation to flow toward apredetermined location of the arms, such as toward a front region.

In another embodiment, one or both arms may have a portion that isflexible or movable relative to another portion of the arm. For example,a tip region of one or both of the arms may pivot or rotate relative toa second region of the arm. The rotatable or pivotable portion may bespring-loaded toward a default position.

Turning to FIGS. 8 and 9, the hinge pin 86 on the second arm 84 mayextend into a pin slot 88 in the first arm 82. A jaw spring 110 may beattached to the first arm 82 with set screws 112. The jaw spring 110exerts upward force on the hinge pin 86, holding the jaws together, asshown in FIG. 8.

Referring to FIG. 9, as with the tool 20, when the jaws clamp onto anobject with a force exceeding a pre-set amount, the force of the jawspring 110 is overcome. The hinge pin 86 moves from the up positionshown in FIG. 8, to the down position shown in FIG. 9, where the jawsare spaced apart and may be largely parallel to each other. The jawspring 110 may be a spring wire. Other forms of springs such as coilcompression springs, leaf springs and non-metal spring elements, such asresilient foam, rubber and plastic elements, may also be used.

As described, the pivot pin 42 or 86 provides a pivot point where thearms intersect, with the pivot point moving along a linear orcurvilinear pathway up or down to accommodate the thickness of theclamped object. The spring moves the pivot pin. If the spring constantis too high, the pivot point will not move enough to keep the jawsparallel. Similarly, if the spring constant is too low, the spring willallow the pivot pin to move too easily, with the pivot pin moving toofar to keep the jaws parallel. The spring constant may be selected basedon the characteristics of the object to be clamped, or in surgicalapplications, the stiffness of the tissue to be operated on.

Relative to surgical uses, testing on calf liver revealed that 5N offorce was sufficient to fully collapse the calf liver, suggesting that aspring force on the order of 5N may be suitable in some embodiments ofthe tool 20. As shown in FIGS. 8 and 9, securing the jaw spring 110 inplace with fasteners 112 allows the spring to be quickly and easilyreplaced. This allows the tool 80 to be adapted for different uses.

In addition to providing more even and uniform clamping force along thelong jaws, the capability of providing parallel jaws, in surgicalapplications, also promotes an even seal along the long jaws.Substantially parallel jaws also tends to obviate any need for segmentedRF tips on the jaws to allow different power or time settings along thejaw's length, and the associated added RF generator complexity and leadwires. In an embodiment, the jaws initially pivot or rotate relative toone another when initially opened and then transfer to parallel positionand translate relative to one another without any pivoting after thearms have initially achieved a certain level of movement relative to oneanother.

Turning to FIGS. 10-12, a third hand tool 150 may be the same as thesecond tool configuration 80 shown in FIGS. 4-9, with the followingchanges. A first arm 152 is divided into a front segment 154 pivotallyattached to a rear segment 156 via an arm hinge pin 158. As shown inFIGS. 11 and 12, an arm spring 160 extends between the front segment 154and the rear segment 156. The arm spring 160 may be provided in the formof a spring wire, or as another type of spring similar to thealternative spring options discussed above for the jaw spring 110. Thearm spring 160 may be positioned within a spring slot 162 in the topsurface of the front and rear segments.

As shown in FIG. 11, the central section of the arm spring 160 may besupported on a curved arch surface 166 extending over the hinge pin 158,to reduce bending stresses on the arm spring 160. The ends of the armspring 160 may be positively attached to the front and rear segments viaset screws, bonding, welding, etc. Alternatively, as shown in FIGS. 11and 12, the arm spring 160 may be held in place via spring force, withthe front end of the arm spring 160 captured under a bridge section 164on the front segment, as shown in FIG. 12, and with the back end of thearm spring 160 captive within a slot in the rear segment 156, as shownin FIG. 11. Capturing the arm spring 160, rather than positivelyattaching the arm spring 160 to the segments allows the arm spring 160to move slightly relative to the arm segments when the rear segmentpivots relative to the front segment, which may simplify the hingedesign.

An embodiment of arm spring 160 resists any deflection until the desiredcompression force limit is reached, so that the tool 150 would have afamiliar feel and operation in the surgeon's hand. Such man arm spring160 also then freely allows deflection when the desired compressionforce is exceeded, to as to precisely limit the compression force.Alternative spring configurations may be used to simulate such a spring.For example, laterally curved leaf springs, collapsing hollow tubesprings, and similar alternatives may be used in place of a solid roundwire to better achieve preferred handling characteristics of the tool150.

The arm spring 160 is pre-loaded or tensioned so that it exerts torqueacting counterclockwise about the arm hinge pin 158 in FIG. 11.Consequently, the arm spring 160 holds the rear segment 156 in astraight or locked out position as shown in FIGS. 11 and 12. In ordinaryuse with nominal clamping force applied, the tool 150 operates in thesame way as the tool 80 shown in FIGS. 4-6. However, if excessive forceis applied, the arm spring 160 will bend, allowing the rear segment 156of the first arm 152 to pivot about the arm hinge pin 158 downwardtowards the second arm 180. Consequently, the clamping force applied bythe jaws is automatically limited. As a result, inadvertent crushing ofthe clamped object is avoided. Damage to the long slender jaws caused byinadvertently clamping down on a hard object is also avoided. The armspring 160 may be selected to have a spring constant which limits theclamping force to a desired maximum, for example 3-5 Newtons.

Referring back to FIGS. 10 and 11 the rear arm segment 154 may have anupward curve, or an upward angle AA of 10-35 degrees, to provideclearance for pivoting movement of the rear arm segment when thecompression force limit is exceeded. The second arm 180 may also curveaway or extend at angle away from the first arm 150 for the samepurpose. The pivoting design of the first arm 152 may optionally be usedon the second arm 180, or on both arms.

Also as shown in FIGS. 10 and 11, the arm hinge pin 158 may generally belocated at a midpoint between the handle loop 26 and the jaw hinge pin86. Of course, the specific position of the arm hinge pin 158 may beshifted to the front or back of the first arm, depending on the toolapplication.

FIG. 13 shows a fourth tool embodiment 190 having a first arm 192 and asecond arm 194 which may be a mirror image of the first arm 192. Thearms 192 and 194 are connected by an X-linkage 196. The front ends ofthe X-linkage may be pivotally pinned to the arms via front pins 204,and the back ends of the X-linkage having slide pins 200 in slots 202.The X-linkage 196 keeps the arms parallel, as the arms opened andclosed.

FIG. 14 shows a portion of the tool embodiment at the juncture betweenthe handle section 300 and the arms 192 and 194. A flexure elementformed of an elongated, cantilevered arm 305 is positioned at thejuncture in a manner that interacts with the arms 192 and 294 in amanner that maintains the arms in a parallel position when the arms areclamping something, such as when clamping tissue. The arm 305 ismechanically coupled to a structure positioned between the arms of thehandle section 300.

FIG. 15 shows a perspective, enlarged portion of one of the arms 192.FIG. 16 shows a side view of the arm 192. An electrode 307 removablyattaches to the arm 192 along the length of the arm 192. In an exampleembodiment, the electrode 307 includes one or more protrusions 309 thatlockingly mate with complementary key-shaped openings 311 of the arm192. For example, the protrusions 309 can mate with the openings 311 ina slide and lock manner such that the protrusions are inserted into theopenings 311 and then are slide along a key-shaped portion of theopenings to lock therein. In another embodiment, the protrusions snapinto and lockingly engage with the openings such as in a press fitmanner. Other mechanisms for coupling and locking the electrode to thearms are within the scope of this disclosure. For example, the electrodemay slide onto the arm such as in a front-loading manner such that theelectrode slides into or onto the arm from the front of the device. Inanother embodiment, the protrusions are on the arm and the openings areon the electrode. A similar arrangement can be used for the other arm194.

In an embodiment, at least a portion of the device is disposable andanother portion of the device is reusable. For example, as shown in theembodiment of FIGS. 17 and 18, the tool 20 includes a disposable pair ofremovable arms or jaws 313 that removably mate with a handle section 300that is reusable. The jaws 313 can removably mate with or otherwiseremovably couple to the handle section 300. This can occur using any ofa variety of mechanisms, such as, for example, in a sliding tongue andgroove mechanism wherein the arms slidingly engage and lock with thehandle section 300.

FIG. 17 shows the jaws 313 separated from the handle section 300. FIG.18 shows the jaws 313 attached to the handle section 300. An arrow 320represents a sliding movement in which the jaws 313 are slidinglyengaged with the handle section 300 by sliding or pushing the jaws 313toward the handle section 300. It should be appreciated that the jaws313 and the handle section 300 can be attached in a variety of mannersusing various mechanisms. In addition, the movement that engages thejaws 313 with the handle section 300 can be a linear movement, a curvedor rotational movement, or a combination thereof. As shown in FIG. 18, abiasing member, such as a spring 317, can be positioned between the twoarms of the handle section. The biasing member can resist or dampenmovement of one of the arms toward the other arm so that the jaws do notsuddenly clamp down on one another.

As in the previous embodiments, the jaws 313 can include a first armwith a first jaw and a second arm with a second jaw that are movablyattached to one another such as in a pivoting or hinged manner. In thisregard, the embodiment of FIGS. 17 and 18 can include any of a varietyof mechanisms for pivoting the jaws relative to one another includingany of the hinge mechanisms described herein.

As discussed, the tool can include a drip line or an irrigation linecomprised of tubing through which fluid can flow, wherein the fluid canbe flowed into or through the jaws and released for providing irrigationto an area of use. In addition, the tool can also include a suction linecomprised of a tube through which a vacuum or negative pressure can beapplied for applying suction to a region of the jaws. It can bedesirable or necessary for at least a portion of the irrigation lineand/or the suction line to transition across the junction between theremoval jaws 313 and the handle section 300. In this regard, a couplingmechanism is positioned at or between the junction of the jaws 313 inthe handle section 300. Other lines can also be included, such as one ormore electrical or other power lines. Any of the lines can include fluidconduits, such as tubing, and power conduits, such as electrical wire.

FIG. 19 shows a schematic representation of a coupling mechanism 400that couples the irrigation line of the jaws 313 with a correspondingirrigation line of the handle section 300. Likewise, the couplingmechanism 400 also couples a vacuum line of the jaws 313 with acorresponding portion of the vacuum line of the handle section 300. Thecoupling mechanism 400 includes a distal portion 405 on the jaws 313 anda corresponding proximal portion 410 on the handle section 300. Thedistal portion 405 can removably attach to the proximal portion 410 suchthat when attached, the distal portion 405 and the proximal portion 410collectively form one or more conduits through which irrigation and/orvacuum can be transmitted between the handle section 300 and the jaws313. In this manner, the jaws 313 can be removably attached and detachedrelative to the handle section 300 while easily and convenientlymaintaining a continuous suction line and irrigation line between thejaws 313 and the handle section 300 when attached.

As mentioned, the coupling mechanism 400 is not limited to coupling anirrigation line and a suction line but can rather include couplings forother features. For example, the coupling mechanism 400 can also includethe capability to couple power lines, such as electrical lines, betweenthe handle section 300 and the jaws 313. In an embodiment, the couplingmechanism includes a three-port cable that includes a power line, asuction line, and an irrigation line or any combination thereof, toenable power, suction, and irrigation.

FIGS. 20 and 21 show another embodiment of a hand tool 2000, whichincludes a handle section 300 and jaws 313 formed of a first jaw and asecond jaw that are mechanically linked in a scissor configuration. Thefirst jaw 24 and the second jaw 54 can vary in shape and include groovedsurfaces that contact one another. The surfaces can have uneven groovesto increase or decrease surface area to bias RF sealing in differentareas of the jaws. Internal channels in the jaws provide fluid pathwaysfor suction and/or irrigation. In addition, the jaw thickness can bemodulated to induce more flex at the distal end of the jaws such as toeven out a clamping force onto tissue.

FIG. 22 shows an enlarged view of a distal region of the jaws. The upperfirst jaw 24 includes a distal flex section 2005 that is pivotablyattached to a proximal section about a hinge joint 2205. This permitsthat distal flex section 2005 to flex, rotate, move, or otherwise adjustin position relative to the proximal section. The flex enables sealingof tissue that is uneven in thickness, such as tissue that is thinner ata distal section relative to a proximal section of the jaws. The handtool can include more than one such flex sections 2005 on the firstand/or second jaws to enable even application of pressure to tissue. Thejaws can be insulated with a ceramic coating to prevent RF energyleakage to surrounding tissue during use. The jaws of the section 2205define an elongated space, groove, or slot 2210 that extends entirelythrough the device. As described below, the slot 2210 provides apassageway through which a blade can be inserted for cutting tissue.

The flex section 2005 may be biased in any direction using a biasingmember, such as a spring, including for example a torsion spring, leafspring, linear spring or other spring. The spring can be configured toprovide pressure toward tissue. The jaws can also flex flat against oneanother when clamping onto tissue.

In an embodiment, the joint 2205 is electrically conductive to transmitpower from the proximal section of the jaw to the distal flex section2005. The upper and/or lower jaw can be segmented to have multipleelectrodes and be driven by different levels of RF power. To ensure evensealing of tissue, a distal region can require more heat or pressure toseal tissue properly.

As mentioned, the tool 20 includes a slot 2210 that provides apassageway through which a blade can be inserted for cutting tissue.This is described in more detail with reference to FIG. 23, which showsthe tool 20 and a blade assembly formed of a blade 2310 attached to ahandle 2320. FIG. 23 shows a side view of the blade assembly (on theleft-most end of FIG. 23) and a front view of the blade assembly(adjacent to the right of the side view). A saddle-like cover or shroud2325 covers at least a portion of the blade 2310 such that a distal-mosttip or cutting edge of the blade 2310 extends distally outward of theshroud. A bottom or distal tip of the shroud 2325 is saddle-shaped asbest shown in the front view of the blade assemble. The saddle-shapeprovides the shroud 2325 with a pair of side protrusions that are sizedand shaped relative to one another so as to hug or be positionedadjacent the outer, lateral side surfaces of the tool as the tip of theblade 2325 is inserted into and through the slot 2210. In this manner,the distal tip or edge of the blade 2310 can be inserted into the slot2210 while the bottom protrusions of the shroud 2325 hug the outer sidesurfaces of the tool. The shroud can be made of various materialsincluding a rigid or flexible material. When flexible, the shroud candeform around the shape of the tool 20 as the blade is inserted throughthe slot 2210.

With reference still to FIG. 23, a cable assembly 2335 is attached tothe tool 20 such that it extends from the handle portion to the jawportion. The cable assembly 2335 includes one or more internal cables orconduits therethrough, such as Litz style wire. In an example, the cableassembly 2335 includes three internal cables including a cable adaptedfor suction, a cable adapted for energy transfer, and a cable adaptedfor irrigation. A proximal end of the cable assembly 2335 can include asocket that permits the cable(s) to be attached to one or more source(s)of suction, energy, and/or irrigation.

In addition, any of the embodiment of the hand tool described herein canbe configured for laparoscopic use and/or robotic use. In this regard,the hand tool can be used in laparoscopic procedures.

The type of coupling mechanism can vary and can include, for example, atongue and groove coupling mechanism, a male-female coupling mechanism,a threaded coupling mechanism, or any other mechanism for mechanicallycoupling fluid and/or power lines. The coupling mechanism can includefluid lines through which fluid can travel and power lines through whichan electrical current can travel.

As used here, unless otherwise stated, “in contact with” means elementsactually or nominally touching each other, such as elements 1 or 2 mmapart. The term “linearly” is used here to distinguish from pivotalmovement, and does not connote any geometrically precise linearcharacteristic. The term “joined”, “attached” or “connected to” meanstemporarily or permanently physically linked with, or integral with, aswith different sections of a single integral element.

The elements described above may of course also be applied in otherproducts having similar elements, movements or requirements. Theseinclude, for example door hinges, to create a weather tight seal, or asa hinge on a trunk or case, or a briefcase allowing for expansion whenfilled over capacity. The elements and principles described may also beapplied to a gas or fluid tank cap to regulate or relieve pressure, oras a pouch sealer to equalize pressure on the seal.

While this specification contains many specifics, these should not beconstrued as limitations on the scope of an invention that is claimed orof what may be claimed, but rather as descriptions of features specificto particular embodiments. Certain features that are described in thisspecification in the context of separate embodiments can also beimplemented in combination in a single embodiment. Conversely, variousfeatures that are described in the context of a single embodiment canalso be implemented in multiple embodiments separately or in anysuitable sub-combination. Moreover, although features may be describedabove as acting in certain combinations and even initially claimed assuch, one or more features from a claimed combination can in some casesbe excised from the combination, and the claimed combination may bedirected to a sub-combination or a variation of a sub-combination.Similarly, while operations are depicted in the drawings in a particularorder, this should not be understood as requiring that such operationsbe performed in the particular order shown or in sequential order, orthat all illustrated operations be performed, to achieve desirableresults.

Although embodiments of various methods and devices are described hereinin detail with reference to certain versions, it should be appreciatedthat other versions, embodiments, methods of use, and combinationsthereof are also possible. Therefore the spirit and scope of theappended claims should not be limited to the description of theembodiments contained herein.

1. A hand-held tool comprising: a first arm having a first jaw sectionand a first handle section; a second arm having a second jaw section anda second handle section; a pivot connection pivotally attaching thefirst arm to the second arm, wherein the the pivot connection is fixedrelative to the first arm and movable between first and second positionsrelative to the second arm; and a jaw spring urging the pivot connectioninto the first position; an irrigation line through which a fluid canflow, wherein the irrigation line extends from the first and secondhandle sections to the first and second jaw sections; a suction linethrough which a vacuum pressure can be applied, wherein the suction lineextends from the first and second handle sections to the first andsecond jaw sections; wherein the first handle section and second handlesection are removably connected to the first jaw and the second jaw. 2.The tool of claim 1, wherein the first handle section and second handlesection removably connect to the first jaw and the second jaw via asliding connection.
 3. The tool of claim 1, wherein the irrigation lineincludes a coupling mechanism that couples a jaw portion of theirrigation line to a handle portion of the irrigation line.
 4. The toolof claim 1, wherein the suction line includes a coupling mechanism thatcouples a jaw portion of the suction line to a handle portion of thesuction line.
 5. The tool of claim 1 wherein the pivot connectioncomprises a pin fixed to the first arm and extending into a slot in thesecond arm.
 6. The tool of claim 5 wherein the spring comprises a wirespring attached to the second arm.
 7. The tool of claim 1 wherein thefirst jaw section is spaced apart from and substantially parallel to thesecond jaw section when the pivot connection is in the second position.8. The tool of claim 7 wherein the first and second jaws are movableinto parallel positions with the pivot connection in the first positionor in the second position.
 9. The tool of claim 1 wherein the first jawsection and the second jaw section each have a front end and a back end,and wherein front and back ends of the first and second jaw sections arespaced apart from each other, respectively, when the pivot connection isin the second position.
 10. The tool of claim 9 wherein the spacingbetween the front and back ends of the first and second jaw sectionsvaries by less than 2 mm when the pivot connection is in the secondposition.
 11. The tool of claim 1 further comprising a first electrodeon the first jaw section and a second electrode on the second jawsection, and wire leads on at least one of the first and second armsconnecting to the first and second electrodes.
 12. The tool of claim 9further comprising an irrigation line in or on at least one of the firstand second arms connecting to the first or the second jaw sections, andan aspiration line in or on at least one of the first and second armsconnecting to the first or the second jaw sections.
 13. The tool ofclaim 1 further comprising a finger on the second arm for limitingmovement of the pivot connect